Can understanding the mechanics of the throwing motion help to understand why it may cause shoulder pain, the symptoms of a shoulder problem, the diagnosis, and the treatment options available?
Throwing a Ball and Shoulder Pain
The throwing motion is a complex shoulder movement that requires the mechanics of muscles, tendons, joints, ligaments, and bones. They all must move in a synchronized and stable pattern to move the shoulder joint. When these mechanics are interrupted or altered, inflammation can result in pain symptoms. (Wardell M., Creighton D., & Kovalcik C., 2022)
The labrum stabilizes the ball in the socket of the shoulder.
The shoulder blade rotation coordinates with the arm to ensure mobility. (Itoigawa Y. et al., 2023)
The throwing motion generates high torque and acceleration forces acting on the shoulder joint and the surrounding muscles, ligaments, and tendons.
Causes of Pain
Pain when throwing can come from the:
Shoulder blade
Shoulder joint – cartilage and labrum
Rotator cuff muscles and tendons
Nerves that control the muscles’ function
The shoulder blade is attached to the upper back by ligaments, muscles, and tendons. The various muscles and tendons that control the movement of the shoulder blade impact movements. Abnormalities of any area can lead to shoulder dysfunction and pain when throwing. (Wardell M., Creighton D., & Kovalcik C., 2022) The most common is the tightness of the posterior shoulder capsule, causing a loss of normal internal rotation of the shoulder. If this is causing pain, individuals may notice that they can’t reach up as high on the side with the painful shoulder when reaching behind their back.
Symptoms
Whether an athlete or playing catch in the backyard, shoulder function abnormalities can cause significant pain. Some symptoms include.
Aching Pain
Often deep in the shoulder or extending down the upper arm.
Dead Arm
Lack of strength in the throwing motion.
Pain at Night
Pain can awaken you from sleep.
Diagnosis
Finding a healthcare provider familiar with sports injuries can be helpful. They can best determine if a structural abnormality needs to be addressed. (American Academy of Orthopaedic Surgeons, 2021)
Treatment
Most can improve with nonsurgical treatments. The earliest phase of treatment is resting the joint and reducing inflammation. Treatments can include:
Ice
Anti-inflammatory medications
Cortisone injection
Once the inflammation has subsided, the source of the discomfort can be addressed.
Physical Therapy
Therapy can include:
A structured shoulder stretching and strengthening program will help.
The physical therapist will focus on scapular mobility when managing shoulder joint problems.
Stretching to improve internal rotation or any other lost motion can help allow a more normal throwing motion.
Strength exercises are often aimed at the rotator cuff, as these muscles initiate proper shoulder movements and stabilize the shoulder joint.
Maintaining flexibility and strength of the periscapular muscles (muscles that attach to the scapula bone) is important to ensure that the scapular movements are coordinated with the throwing motion.
If improvements are not made within three months of therapy, or individuals can’t return to competitive sports within six months. In that case, the individual may need to return to their healthcare provider or see an orthopedic specialist who may recommend surgery. (American Academy of Orthopaedic Surgeons, 2024)
Injury Medical Chiropractic and Functional Medicine Clinic
As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions.
Wellness & Nutrition: Personalized plans to optimize health and prevent disease.
Chronic Pain Management: Non-invasive solutions for fibromyalgia, sciatica, and low back pain.
Personal Injury & Auto Accident Care: Tailored rehabilitation for whiplash, soft tissue injuries, and more.
Sports Injuries & Orthopedic Care: Treatment for sprains, strains, and complex injuries.
Functional Medicine: Root-cause analysis for chronic disorders, incorporating nutrition, lifestyle, and environmental factors.
Neuromusculoskeletal Health: Care for neck pain, migraines, herniated discs, and scoliosis.
Our clinic integrates Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges.
At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after frustrating injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.
Lumbar Spine Injuries in Sports: Chiropractic Healing
References
Wardell, M., Creighton, D., & Kovalcik, C. (2022). Glenohumeral Instability and Arm Pain in Overhead Throwing Athletes: A Correlational Study. International journal of sports physical therapy, 17(7), 1351–1357. https://doi.org/10.26603/001c.39800
Itoigawa, Y., Koga, A., Morikawa, D., Kubota, A., Uehara, H., Maruyama, Y., Takazawa, Y., & Ishijima, M. (2023). Posterior shoulder stiffness was associated with shoulder pain during throwing in college baseball players: assessment of shear wave elastography. European journal of orthopaedic surgery & traumatology: orthopedie traumatologie, 33(4), 1237–1244. https://doi.org/10.1007/s00590-022-03286-z
American Academy of Orthopaedic Surgeons. (2021). Shoulder Injuries in the Throwing Athlete. https://orthoinfo.aaos.org/en/diseases–conditions/shoulder-injuries-in-the-throwing-athlete/
American Academy of Orthopaedic Surgeons. (2024). Shoulder Impingement/Rotator Cuff Tendinitis. https://orthoinfo.aaos.org/en/diseases–conditions/shoulder-impingementrotator-cuff-tendinitis
For individuals wanting to improve core stability, can using the right size exercise or stability ball help improve workouts and achieve goals?
Exercise Stability Ball
An exercise ball, stability ball, or Swiss ball is a piece of fitness equipment used in gyms, Pilates and yoga studios, and HIIT classes. (American Council on Exercise. 2014) It is inflated with air to supplement bodyweight workouts or improve posture and balance. It can also be used as a chair. They add a core stability challenge to almost any exercise (American Council on Exercise, N.D.) Getting the appropriate exercise ball size and firmness for your body and purpose will ensure an optimal workout.
Size
The exercise ball size should be proportional to individual height.
Individuals should be able to sit on the ball with their legs at a 90-degree angle or slightly more, but not less.
The thighs should be parallel to the ground or angled slightly down.
With the feet flat on the floor and the spine straight, not leaning forward, backward, or sideways, the knees should be even with or slightly lower than the hips.
Getting the right exercise ball for weight is also important. Individuals who are heavy for their height may need a larger ball to keep the knees and legs at the correct angle. It is recommended to check the weight rating of the ball, its durability, and its high burst resistance before buying.
Inflation
Individuals want a little give on the ball’s surface for exercise. When sitting on the exercise stability ball, body weight should create a little seat and provide more stability. More importantly, it allows sitting evenly on the ball, which is essential for exercising with proper spinal alignment. (Rafael F. Escamilla et al., 2016) Inflation is a matter of preference, but the more inflated the ball is, the more difficult it will be to balance the body, whether sitting or in other positions. It is recommended not to over-inflate the ball at the risk of bursting. The ball may require reinflation occasionally, so many are sold with a small pump for this purpose.
Exercises and Stretches
Exercise balls are highly versatile, inexpensive, and easy-to-use workout tools. They are beneficial for improving core strength and stability. Ways to be used include:
Target exercises for core activation and strengthening.
At Injury Medical Chiropractic and Functional Medicine Clinic, we focus on what works for you and strive to create fitness and better the body through research methods and total wellness programs. These natural programs use the body’s ability to achieve improvement goals and athletes can condition themselves to excel in their sport through proper fitness and nutrition. Our providers use an integrated approach to create personalized programs, often including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles.
Home Exercises For Pain Relief
References
American Council on Exercise. Sabrena Jo. (2014). Core-strengthening Stability Ball Workout. ACE Fitness® & Healthy Lifestyle Blog. https://www.acefitness.org/resources/pros/expert-articles/5123/core-strengthening-stability-ball-workout/
American Council on Exercise. (N.D.). Exercise Database & Library. Featured Exercises from ACE. Stability Ball. Healthy Living Blog. https://www.acefitness.org/resources/everyone/exercise-library/equipment/stability-ball/
American Council on Exercise. (2001). Strengthen your abdominals with stability balls. Healthy Living Blog. https://acewebcontent.azureedge.net/assets/education-resources/lifestyle/fitfacts/pdfs/fitfacts/itemid_129.pdf
Escamilla, R. F., Lewis, C., Pecson, A., Imamura, R., & Andrews, J. R. (2016). Muscle Activation Among Supine, Prone, and Side Position Exercises With and Without a Swiss Ball. Sports health, 8(4), 372–379. https://doi.org/10.1177/1941738116653931
The workstation is one of the most damaging places you can spend your day when it comes to your spine. Office chairs are not designed to promote good posture or spinal health while desks and computer monitors are notorious for being too low or too high. The result can cause pain in your neck and back, headaches, and a variety of other conditions.� A stability ball could be the answer.
However, if you have a job that requires you to sit at a desk for an extended period, what can you do? Are you stuck with an achy, stiff neck and back because your workstation doesn�t promote a healthy posture? You don�t have to suffer; you can work healthier and smarter. Using an exercise ball as your chair is a great way to combat the painful and even detrimental effects of the traditional desk and chair.
Stability Ball as an Office Chair
A stability ball, also known as a Swiss ball, exercise ball, or physioball, is a large, inflatable ball used for training. A stability ball helps to increase pillar strength, improve stability and have better balance. It is large, making it high enough that it can easily be used as a desk chair.
At least one company has combined the fitness benefits of a stability ball with some of the convenient features of an office chair (wheels, lumbar support, etc.). Gaiam Balance Ball Chairs are stability balls that are intended to be used as chairs. The ball needs to be inflated before use and may need to be reinflated from time to time. It also has a 300-pound weight capacity. It is a somewhat pricier alternative to the plain stability ball.
How Sitting on a Stability Ball Benefits your Spine
There are at least three outstanding benefits you can enjoy by using a stability ball as your chair. Try it for just 30 days and see the difference for yourself. In that time you will see:
Your core muscles are toned. As you balance on the stability ball, it forces you to engage your core muscles including those in your low back, abdominal, and pelvic floor. It will keep your muscles engaged for extended periods of time but also encourage you to move for little extra core work. This, in turn, will help to keep your spine correctly aligned and stabilized.
Your back pain is relieved. Sitting on your stability ball improves your circulation, encouraging blood flow throughout your body. An office chair, on the other hand, does just the opposite. This is helpful in relieving pain. It keeps your spine aligned which also helps with any back pain you may experience. This is in part to the core strength you develop, but also because you are less likely to slouch or sit in a position that puts a strain on your back.
You have better posture.�A better-aligned spine naturally leads to better posture. Sitting on the ball works your core, strengthening those muscles so that your spine is supported, resulting in better posture. You will find that you sit up straighter and over time you will walk taller. Better posture is perfect for your spine, making it more flexible and stronger.
It should be noted that it isn�t healthy to sit in any position for too long. Stand up and move about every hour or so. While the stability ball causes you to change positions throughout the day, you also need full body movement, which includes standing, stretching and walking.
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